本文選題：膳食模式　切入點(diǎn)：肥胖　出處：《中國(guó)疾病預(yù)防控制中心》2013年博士論文　論文類(lèi)型：學(xué)位論文

【摘要】：研究背景 伴隨著經(jīng)濟(jì)的快速發(fā)展,中國(guó)正處于營(yíng)養(yǎng)變遷之中,成年居民超重和肥胖率呈現(xiàn)快速增長(zhǎng)趨勢(shì)。傳統(tǒng)的膳食研究方法主要是探討單一營(yíng)養(yǎng)素或者食物與肥胖的關(guān)系,具有一定的局限性。膳食模式研究是對(duì)整體膳食進(jìn)行分析,能夠更全面實(shí)際地反映食物和營(yíng)養(yǎng)素的綜合效應(yīng),從而更有效地研究膳食與人體健康的關(guān)系。 研究目的 本研究旨在了解我國(guó)成年居民膳食模式特點(diǎn)及變化,分析膳食模式的影響因素,探討不同膳食模式對(duì)成年居民超重和肥胖的影響。 研究?jī)?nèi)容與方法 本研究數(shù)據(jù)來(lái)源于中美合作課題“中國(guó)健康與營(yíng)養(yǎng)調(diào)查”。根據(jù)研究目的,將研究對(duì)象分為兩類(lèi)。第一類(lèi)包括1991-2009年至少參加一次調(diào)查的18～80歲成年居民。采用因子分析方法建立各年居民膳食模式,了解其營(yíng)養(yǎng)特點(diǎn)及影響因素,并分析膳食模式在18年間的變化。第二類(lèi)研究對(duì)象為參加1993年和2009年2次調(diào)查,并有完整數(shù)據(jù)的調(diào)查對(duì)象。采用多水平混合效應(yīng)模型對(duì)縱向追蹤人群進(jìn)行分析,探討不同膳食模式對(duì)我國(guó)成年居民超重和肥胖的影響。 研究結(jié)果 1、從1991年到2009年,中國(guó)成年居民的超重率和肥胖率顯著增長(zhǎng)。超重率從16.1%上升到28.0%,增長(zhǎng)了73.9%。肥胖率從3.0%上升到7.7%,增長(zhǎng)了156.7%。中心性肥胖率從1993年24.2%上升到2009年的44.9%,增長(zhǎng)了85.5%。 2、谷類(lèi)食物主要以大米和面粉消費(fèi)為主。其中大米攝入量呈下降趨勢(shì),面粉攝入量保持平穩(wěn)略有下降。肉類(lèi)食物以豬肉和魚(yú)蝦類(lèi)消費(fèi)為主,攝入量呈上升趨勢(shì)。薯類(lèi)攝入量呈上升趨勢(shì)。豆類(lèi)攝入量略有下降。速食食品和小吃甜點(diǎn)攝入量從2004年開(kāi)始呈現(xiàn)快速上升趨勢(shì)。蔬菜攝入量總體保持穩(wěn)定,男性攝入量約為350g/d,女性攝入量約為330g/d。水果攝入量呈顯著上升趨勢(shì)。蛋類(lèi)攝入量呈上升趨勢(shì),奶類(lèi)攝入量呈現(xiàn)波動(dòng)趨勢(shì)。 3、成年男性和女性居民有4種共同的膳食模式,分別是以大米、蔬菜和豬肉為主要食物的南方模式,以面粉、其他谷類(lèi)和薯類(lèi)為主要食物的北方模式,以奶類(lèi)、水果和蛋類(lèi)為主要食物的零食模式以及以速食食品、奶類(lèi)和小吃甜點(diǎn)為主要食物的速食模式。 4、男性特有的膳食模式是以動(dòng)物性食物、酒類(lèi)和堅(jiān)果為主要食物的酒類(lèi)模式。女性特有的膳食模式,分別是以畜禽肉和魚(yú)蝦類(lèi)為主要食物的肉類(lèi)模式,以薯類(lèi)和其他谷類(lèi)為主要食物的粗糧模式。 5、1993年到2009年間,男性南方模式、肉類(lèi)模式和零食模式的相關(guān)系數(shù)分別為0.62(p0.01)、0.32(p0.01)和0.24(p0.01),女性分別為0.63(p0.01)、0.32(p0.01)和0.05(p0.05)。 6、南方模式、肉類(lèi)模式和零食模式變異中由社區(qū)因素解釋的比例男性分別為66%、17%和18%,女性分別為65%、17%和19%。社區(qū)因素是南方模式變異的主要部分。年齡、教育程度、收入水平、身體活動(dòng)水平和吸煙、飲酒是影響膳食模式的個(gè)體因素。 7、男性南方模式最高5分位發(fā)生超重/肥胖和中心性肥胖的危險(xiǎn)分別是最低5分位的53%和60%。女性南方模式與腰圍呈負(fù)相關(guān)(p0.01)。 8、男性零食模式最高5分位發(fā)生超重/肥胖和中心性肥胖的危險(xiǎn)分別是最低5分位的1.66倍和1.88倍。結(jié)論 1991-2009年,我國(guó)成年居民膳食模式呈現(xiàn)多樣化,并且隨著時(shí)間發(fā)生改變。各種膳食模式中,傳統(tǒng)膳食模式的長(zhǎng)期穩(wěn)定性相對(duì)較高。膳食模式同時(shí)受社區(qū)、個(gè)體和時(shí)間等因素的影響。由于食物構(gòu)成和營(yíng)養(yǎng)成分的差異,膳食模式對(duì)成年居民肥胖的影響不同。以大米、蔬菜和豬肉為主要食物的南方模式,能降低男性發(fā)生超重/肥胖和中心性肥胖的危險(xiǎn)性；并與女性腰圍呈負(fù)相關(guān),是女性腰圍的保護(hù)因素。零食模式與男性超重/肥胖和中心性肥胖呈正相關(guān),是男性超重/肥胖和中心性肥胖的危險(xiǎn)因素。
[Abstract]:Research background
With the rapid development of economy, Chinese is in the nutrition transition, adult overweight and obesity rate showed a rapid growth trend. The dietary traditional research method is mainly to explore the relationship between single nutrients or food and obesity, have some limitations. The research is on the overall dietary patterns of dietary analysis, can be more comprehensive and practical to reflect the comprehensive effect of food and nutrients, so as to effectively study the relation between diet and health.
research objective
The purpose of this study is to understand the characteristics and changes of dietary patterns of Chinese adults, analyze the influencing factors of dietary patterns, and explore the effects of different dietary patterns on overweight and obesity in adults.
Research content and method
The data come from the Sino US cooperation project "Chinese health and nutrition survey. According to the research purpose, the research object will be divided into two categories. The first category includes 18~80 1991-2009 years old adult residents participated in at least one investigation. Using the factor analysis method to establish the dietary pattern, understand its nutritional characteristics and influence factors. And analyze the changes in dietary patterns in 18 years. Second the research object for the 1993 and 2009 2 survey respondents, and complete data. By using multilevel mixed effects model for longitudinal population analysis, discuss the influence of different dietary patterns on overweight and obese adults in China.
Research results
1, from 1991 to 2009, the overweight rate and obesity rate of Chinese adults increased significantly. The overweight rate increased from 16.1% to 28%, an increase of 73.9%.. The obesity rate increased from 3% to 7.7%, increasing the 156.7%. central obesity rate from 24.2% in 1993 to 44.9% in 2009, an increase of 85.5%..
2, cereals mainly rice and flour consumption. The rice intake decreased, flour intake remained stable slightly. Meat to pork and fish consumption, intake increased. Potato intake increased. Beans intake decreased slightly. Fast food and snacks intake began a rapid upward trend from 2004. Vegetable intake remained stable overall, male intake is about 350g/d, about 330g/d. women's intake of fruit intake showed a significant increase trend. Egg intake increased, milk intake showed a trend of fluctuation.
3, adult male and female residents there are 4 kinds of common dietary patterns, respectively with rice, vegetables and pork as the main food of the south, with flour and other cereals and potato as the main food of the north, with milk, fruit and eggs as the main food snacks mode and at fast food, milk and snacks dessert is the main food fast food.
4, the male specific dietary pattern is a wine pattern based on animal food, wine and nuts. The unique dietary patterns of females are meat models with livestock, poultry, fish and shrimp as main foods, and coarse grains as main food of potato and other cereals.
From 51993 to 2009, the correlation coefficients of male Southern mode, meat mode and snack mode were 0.62 (P0.01), 0.32 (P0.01) and 0.24 (P0.01) respectively, and the females were 0.63 (P0.01), 0.32 (P0.01) and 0.05 (P0.05), respectively.
6, the pattern of the south, explained by the community factors model and meat snacks pattern variation in the proportion of males were 66%, 17% and 18%, women were 65%, 17% and 19%. is the main part of the southern community factors variation mode. Age, education level, income level, level of physical activity and smoking, drinking is individual factors. Dietary patterns.
7, the highest 5 percentile of male Southern mode is the risk of overweight / obesity and central obesity, which are 53% and 60%. of the lowest 5 percentile, respectively. There is a negative correlation between women's southern pattern and waist circumference (P0.01).
8, the risk of overweight / obesity and central obesity in the highest 5 division of the male snack pattern was 1.66 and 1.88 times as high as the lowest 5.
1991-2009 years, dietary patterns among Chinese adults are diversified, and change over time. Various dietary patterns, the long-term stability of the traditional dietary pattern is relatively high. At the same time by the dietary pattern of individual and community, impact time and other factors. Because the food composition and nutrition differences, effects of dietary patterns on obese adult residents different. In rice, vegetables and pork as the main food of the south, can reduce the risk of male obesity and overweight / obesity center; and negatively correlated with female waist circumference, female waist circumference is a protective factor. Male snacks pattern and overweight / obesity and central obesity was positively related to factors of obesity the risk of obesity and overweight / male center.

【學(xué)位授予單位】：中國(guó)疾病預(yù)防控制中心
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R151.4

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